Table 1 Clinical characteristics and antibiotic use pattern in surgery in hospitals in Ghana
Characteristics | Number of surgical patients on admissionn = 540 | Number of surgical patients on antibiotics n = 382 | Prevalence (95% CI) of antibiotic use amongst surgical patients | Odds ratio (95% CI) Univariable analysis | p-value | Odds ratio (95% CI) Multivariable analysis | Number of antibiotic prescriptions n = 636 [Number of prescriptions / persons on antibiotic] |
|---|---|---|---|---|---|---|---|
Hospital type | |||||||
District Hospital | 186 | 120 | 64.5 (56.0–73.1) | 1.0 | 179 [1.49] | ||
Regional Hospital | 100 | 84 | 84.0 (68.3–99.7) | 2.9 (0.8–9.9) | 0.08 | 166 [1.98] | |
Tertiary Hospital | 254 | 178 | 70.1 (64.8–75.3) | 1.3 (0.8–2.0) | 0.2 | 291 [1.63] | |
Surgical specialty | |||||||
Dental (+ MXF) Surgery | 13 | 9 | 69.2 (52.2–86.3) | 1.0 | 19 [2.1] | ||
Ear, Nose and Throat | 8 | 7 | 87.5 (50.6–124.4) | 3.1 (0.1–95.1) | 0.5 | 10 [1.43] | |
General Surgery | 386 | 274 | 71.0 (61.3–80.7) | 1.1 (0.4–2.7) | 0.8 | 466 [1.70] | |
Neurosurgery | 24 | 15 | 62.5 (62.5–62.5) | 0.7 (0.3–1.6) | 0.4 | 26 [1.73] | |
Ophthalmology | 2 | 0 | 0.0 | – | 0 [0.00] | ||
Orthopedics and trauma | 61 | 40 | 65.6 (62.1–69.1) | 0.8 (0.4–1.9) | 0.7 | 52 [1.30] | |
Pediatric surgery | 33 | 25 | 75.8 (67.7–83.8) | 1.3 (0.6–3.4) | 0.4 | 42 [1.68] | |
Urology | 13 | 12 | 92.3 (92.3–92.3) | 5.3 (2.3–11.9) | 0.001 | 5.0 (1.5–15.9) | 21 [1.75] |
Age group | |||||||
0–12 (Children) | 82 | 62 | 75.6 (64.7–86.5) | 1.0 | 111 [1.79] | ||
13–17 (Adolescents) | 33 | 21 | 63.6 (41.2–86.1) | 0.6 (0.2–1.5) | 0.2 | 36 [1.71] | |
18–29 (Young adult) | 84 | 58 | 69.0 (61.6–76.5) | 0.7 (0.4–1.4) | 0.3 | 100 [1.72] | |
30–39 (Thirties) | 75 | 51 | 68.0 (49.6–86.4) | 0.7 (0.4–1.3) | 0.2 | 80 [1.57] | |
40–64 (Middle age) | 170 | 121 | 71.2 (64.0–78.4) | 0.8 (0.4–1.5) | 0.4 | 198 [1.64] | |
> 65 (Old age) | 96 | 69 | 71.9 (61.7–82.6) | 0.8 (0.4–1.9) | 0.6 | 111 [1.61] | |
Gender | |||||||
Male | 340 | 243 | 71.5 (63.1–79.8) | 1.0 | 397 [1.63] | ||
Female | 200 | 139 | 69.5 (62.1–76.9) | 0.9 (0.6–1.3) | 0.6 | 239 [1.72] | |
McCabe Score | |||||||
Non-fatal | 497 | 356 | 71.6 (63.9–79.3) | 1.0 | 594 [1.67] | ||
Rapidly fatal | 9 | 6 | 66.7 (16.7–116.6) | 0.8 (0.1–5.8) | 0.8 | 8 [1.33] | |
Ultimately fatal | 34 | 20 | 58.8 (45.6–72.0) | 0.6 (0.3–1.2) | 0.1 | 34 [1.70] | |
Surgical procedure done | |||||||
No | 278 | 175 | 63.1 (50.9–75.3) | 1.0 | 293 [1.67] | ||
Yes | 262 | 207 | 77.6 (72.1–85.0) | 2.1 (1.5–3.1) | 0.02 | 2.2 (1.0–4.6) | 343 [1.66] |
HAI documented | |||||||
No | 478 | 323 | 67.6 (59.8–75.4) | 1.0 | 522 [1.62] | ||
Yes | 62 | 59 | 95.2 (86.8–103.6) | 9.4 (1.5–60.3) | 0.02 | 8.9 (1.4–56.5) | 114 [1.93] |
Types of infections | |||||||
BSI | 4 | 4 | 100.0 | 9 [2.25] | |||
Pneumonia | 7 | 7 | 100.0 | 18 [2.57] | |||
SSI | 36 | 33 | 91.7 (79.5–103.8) | 61 [1.85] | |||
UTI | 7 | 7 | 100.0 | 11 [1.57] | |||
Other | 8 | 8 | 100.0 | 15 [1.88] | |||